Supracondlar humeral fractures: The epidemiology and short term treatment outcome among children admitted at Muhimbili National Hospital/ Muhimbili Orthopaedic Institute

Discuses and gynecological diseases. This may be explained by its relative accessibility, affordability, and safety as compared to other sophisticated imaging modalities such as CT scan, MRI, and others. However the diagnostic value, i.e. sensitivity, specificity, accuracy, and predictive values, of this imaging technique have not yet been assessed, here in Dar es Salaam. To compare the Ultrasound findings and Operative findings in abdominal lesions at Muhimbili National Hospital. From March 2003 through March 2004, 277 patients were studied. These were patients who under-went abdominal or pelvic ultrasound, or both, followed by either open surgical procedure or endoscopy, due to either surgical or gynecological condition, within the study period. Ultrasound was the screening test whereas surgery and endoscopy were confirmatory. The ultrasound results were compared with the operative or endoscopic findings. The results. A total of 138 patients with supracondylar fractures were admitted in pediatric surgical wards at MNH and MOI accounting for I 4.45% (138/955) of all admissions and 33. l %(138/41 7) of all fractures admitted during the study period. Of these, 79(57.2%) patients fulfilled inclusion criteria. Male to female ratio was 3:1 with mean age of 7.2 years and 6.4 years for males and females respectively. Falling from a height was the main cause of fracture 55.7% (44/79). Extension type of injury was the most common (98.7%) and flexion type 1.3%. Garland’s Type III fractures were the commonest (72.14%), II (19%) and I(8.86%). Only one patient had an open fracture. Almost 62.4% patients had satisfactory carrying angle, 37.6% had poor results presenting with cubitus varus. Mean flexion at 3 month was 123.12 degrees (82.1%). Mean extension was 10.27 degrees (60.7%). Among all patients with supracondylar fractures 71(90%) underwent closed reduction and immobilization with POP, 8(10%) were treated by open reduction and K- wire fixation. The conclusion is Closed reduction and application of a cast was associated with higher percentages of cubitus varus and limited range of movement. It is recommended therefore; that closed reduction with cast application be reserved for undisplaced Gartland's type Ifractures and successfully reduced type II fractures.